Nurses are the backbone of nursing homes, yet many people don’t know the varied roles they have and the importance of their contributions. From looking after the physical comfort of residents to providing important medical care, nurses do it all.
Currently, federal regulations state that nursing homes must have enough nurses available on shift to meet the care needs of each resident. The Bureau of Labor Statistics estimates that there will be 193,100 openings each year over the next decade, and many of these nurses will be needed in the aged care sector.
This article looks at the different types of nurses that work in nursing homes, what their roles are and how they support the health of residents.
What Are The Nursing Roles In a Nursing Home?
There are four types of nurses commonly employed by nursing homes: registered nurses (RNs), licensed practicing nurses (LPNs), certified nursing assistants (CNAs) and nurse practitioners (NPs). Each has a different level of training that allows them to provide a variety of services. These can range from providing personal care to diagnosing conditions. In addition to nurses who take care of residents, there is generally a nurse who supervises other staff members in the facility.
What Is the Role of RNs in Nursing Homes?
RNs have a high level of education, as they require either an associate’s or bachelor’s degree. In a nursing home, their duties include:
- Initiating treatment plans, ensuring residents get the care they need
- Administering medicine orally, topically or through IV
- Providing medical procedures and treatments, including drawing blood and giving injections
- Communicating with families, especially if there are changes in health
- Monitoring health to make sure residents get the correct care
RNs often advance into leadership positions in nursing homes. The most common is the head nurse, or Director of Nursing, who supervises LPNs and CNAs, designates assignments and works out schedules that ensure the correct number of staff are available. RNs may also be charge nurses who oversee all the operations of their unit during a shift.
What Is the Role of LPNs in Nursing Homes?
LPNs complete a 2-year nursing program and provide direct bedside care to nursing home residents. This includes:
- Providing routine care, including assisting with personal hygiene or moving residents out of bed
- Taking vital signs, such as blood pressure, temperature or heart rate
- Providing medical assistance, including monitoring IVs or applying bandages
In essence, their job is to look after the resident’s comfort and take note of any changes. LPNs report any problems to an RN.
What Is the Role of CNAs in Nursing Homes?
CNAs complete shorter training programs to become state-certified. Their general role is to assist LPNs in looking after the comfort of residents. This can include:
- Cleaning, such as changing bed sheets
- Assisting with hygiene, including bathing residents and changing bedpans
- Supporting nutrition by helping residents eat
All tasks CNAs undertake are designated by RNs or LPNs.
What Is the Role of Nurse Practitioners in Nursing Homes?
Nurse practitioners are also called advanced practice registered nurses (APRNs). They are RNs who have either a master’s or doctorate degree. This allows them to provide primary care, helping ease a shortage of doctors.
Various states have different rules about whether NPs can work independently or need the supervision of a doctor. However, in general, they can diagnose problems, prescribe medications and perform some medical procedures. In a nursing home, NPs can provide assessments and treatments for residents after a change in condition, lessening the need for a transfer to a hospital. NPs are also involved in the training and coaching of other staff members, adding to the overall quality of care in a facility.
Do Nursing Home Nurses Receive Special Education?
Nurses of all backgrounds and experience levels work in nursing homes, bringing a variety of skills and knowledge to each facility. However, there are geriatric nursing specialties available for RNs and NPs. Nurses who complete this type of education get specialized training to care for the physical, mental and emotional well-being of older adults. They also focus on conditions that are more common among seniors, such as Alzheimer’s disease, arthritis and osteoporosis.
In addition, most states require that all staff in skilled nursing facilities receive regular training in topics related to senior care. For example, California regulations state nurses must receive training on elder abuse, preservation of patient dignity and privacy, communication skills and the problems and needs of older adults.
How Should Family Members Work With Nurses in Nursing Homes?
Working with family members is part of the job for all nurses in nursing homes. They understand how staying connected to loved ones can help residents, and they are also trained in the legal nuances of medical powers of attorney. If families have questions or concerns about their loved one’s care, nurses are the ones who can provide answers.
Direct care staff, especially LPNs, have the most day-to-day interaction with residents. They can provide information about a resident’s moods, sleep and nutrition. RNs and NPs know about a resident’s medical needs and can explain care plans and medical treatments.
In many cases, a nurse will be the first person to notice a change in a resident’s health. However, if a family member notices changes, it’s important to notify the nurse. They also need to know what’s discussed if a patient goes to a hospital or sees a new physician. This allows them to make the best decisions possible for the resident’s care and incorporate any new information into an existing care plan.